Cancer treatments and
hair loss

Cancer treatments can affect the stages your hair goes through as it grows. Some people find the condition and growth of their hair changes. Others find their hair falls out completely. Your doctor or nurse can tell you if your treatment is likely to affect your hair.

Different treatments will affect your hair differently:

Chemotherapy can cause your hair to fall out or thin. This may happen within 2 to 3 weeks of starting treatment. Hair usually grows back after your treatment finishes. Some chemotherapy drugs can make other hair from your body fall out, such as facial hair and pubic hair. Not all chemotherapy drugs make your hair fall out.

Radiotherapy can cause your hair to fall out, but only in the area being treated. Hair does not always grow back after radiotherapy.

Other cancer treatments, such as hormonal therapy or targeted (biological) therapy, can cause changes to your hair.

Hair loss can be upsetting. You can talk things over with one of our cancer support specialists on 0808 808 00 00.

The treatment side effect I was least looking forward to was hair loss. But I thought, “Maybe this is a chance to have a different hair style”.

Lurline

Chemotherapy

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs work by attacking the cancer cells and disrupting their growth. Chemotherapy can also affect the normal cells in the body, including the cells of the hair follicles.

Cancer cells and hair follicle cells both divide quickly. Chemotherapy treatment affects the normal hair growth cycle and causes hair loss. This is called chemotherapy-induced alopecia (CIA). However, unlike cancer cells, the hair cells quickly recover. This means that if you lose your hair due to chemotherapy, it will almost always grow back when your treatment is over.

Many people assume that they will lose their hair if they have chemotherapy. This is not always true. Many chemotherapy drugs can cause hair loss. But some chemotherapy treatments never cause hair loss. If you don’t lose your hair, this does not mean that the chemotherapy is not working.

Hair loss can vary from mild shedding that is hardly noticeable, to complete hair loss. The amount of hair that falls out depends on:

Before you start chemotherapy, your doctor or chemotherapy nurse will talk to you about side effects and how likely hair loss is.

During chemotherapy

If your hair is going to fall out from chemotherapy, it usually starts 2 to 3 weeks after your first session. Sometimes it can start within a few days, but this is rare. The first thing you may notice is hair on your pillow in the morning. You may also see more hair coming out when you brush, comb or wash it.

Some people only lose some of their hair. The remaining hair will look thinner. For other people, hair may keep falling out over several weeks, leading to total hair loss. Sometimes the hair comes out very quickly over one or two days, which can be very upsetting. You may find that your scalp feels tender.

Your hair loss may continue throughout your treatment and for a few weeks afterwards. Sometimes your hair may start to grow back between treatments and then fall out again.

Some people do not lose their hair, but their hair becomes dry and weak and breaks easily. If this happens to your hair, be careful with your usual hair care routine to help reduce damage.

Will my hair grow back after chemotherapy?

Hair loss from chemotherapy is almost always temporary, so your hair should start to grow back. However, very rarely hair loss can be permanent. When your hair grows back, the new hair can be different to what it was like before treatment. It may:

be curlier, straighter, finer, fluffier or a different colour

grow back unevenly at different speeds.

Facial hair, such as beards and moustaches, may also grow back patchy or a different colour. It may take a while for facial hair to return to what it was like before treatment.

You will probably have a full head of hair 3 to 6 months after treatment ends. After around 12 months, you should have a good idea of how thick your hair will be.

Very rarely, after high doses of chemotherapy, not all hair grows back. Very occasionally, some follicles will not make a new replacement hair. This can make your hair permanently thinner.

If you are concerned about your hair growth after treatment, speak to your doctor or nurse.

My hair started falling out after my first chemo. It’s not been too bad, I have lots of pretty scarves and I know it will grow back.

Sha, discussing chemotherapy side effects

Watch our hair loss video playlist

In these videos, people with experience of cancer and hair loss share their stories. You can also watch tutorials on wigs, headwear and eye make up.

Watch our hair loss video playlist

In these videos, people with experience of cancer and hair loss share their stories. You can also watch tutorials on wigs, headwear and eye make up.

Radiotherapy

Radiotherapy treats cancer by using high-energy rays that destroy the cancer cells, while doing as little harm as possible to normal cells. There are different types of radiotherapy. External beam radiotherapy is given from outside the body. Internal radiotherapy is given using a radioactive material that is placed inside the body.

Radiotherapy will only cause hair loss in the part of the body that is being treated. Hair loss can happen where the radiation beam leaves the body (for example, on the back of the neck), as well as where it enters the body. Ask your cancer specialist or radiographer to show you exactly where your hair may fall out.

The hair loss will also depend on the strength of the dose and the number of treatments you have.

If you have external radiotherapy to your head, you will probably lose some hair from your scalp. This will be in the areas where the radiotherapy beam goes into and out of your scalp.

If you are having treatment for breast cancer, and the radiotherapy includes your armpit, the hair under your arm is likely to fall out.

If you have a beard and have radiotherapy to your head or neck, you may lose your beard.

Hair usually begins to fall out after 2 to 3 weeks. It takes about a week for the hair in the treatment area to fall out completely.

Will my hair grow back after radiotherapy?

Hair re-growth after radiotherapy will depend on lots of things, including the:

type and dose of treatment

number of treatments given

area of your body affected.

Your radiographer can usually tell you before the treatment if your hair is likely to grow back.

If you have been told your hair will grow back, this can start once your skin has healed after treatment. Usually, your hair will start to grow back 3 to 6 months after finishing your treatment. But it may take longer if the treatment dose has been high. The hair that grows back may be thinner, patchy or a different colour.

Sometimes the hair loss is permanent. This can be especially upsetting if it affects the hair on your head. Remember, you can talk things over with one of our cancer support specialists on 0808 808 00 00.

Before I started radiotherapy, I dyed my hair green as a good send-off! My hair is not as thick as it used to be, so I shave it off now.

Vivek

Other treatments

Surgery

If you are having surgery in an area of the body that has hair, such as an operation for a brain tumour, an area of the head will be shaved. This is usually a small area of hair and it will grow back after the operation.

Hormonal and targeted (biological) therapies

Some people notice that their hair becomes thinner while taking a hormonal therapy or targeted (biological) therapy. This is usually mild and the hair grows back at the end of treatment. If you have a beard, you may notice that you have less beard growth.

You may also notice that the hair on your head and body is finer, curlier or more brittle. Each therapy has different possible side effects. Ask your doctor if your hair is likely to change.

Any hair loss from hormonal or targeted therapies nearly always grows back once you have finished treatment. Your doctor can advise you about the type of drug you are taking.

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